Infertility

By John C. Jarrett, M.D. and Deidra T. Rausch, Ph.D.

by Judith Steinberg Turiel

by Joan Marie Butler, RNC,

Clomiphene Citrate, or "Clomid" is often referred to as the "fertility pill". It is used to treat infertile women who have an ovulation problem. It works by helping the pituitary gland (located at the base of the brain) improve the stimulation of developing follicles (eggs) in the ovaries.

Cassy’s birth story is not only a success, but a miracle. We were married August 25, in 1990 and wanted to start a family right away. I was having some problems with my periods and after 5 years of suffering, I was finally diagnosed with moderate Endometriosis.

My husband Bryan and I have been married 10 years. We tried for the first 3 years of our marriage to get pregnant to no avail. Three months after we were married we found out that I had pre-cervical cancer and had laser surgery to get rid of the bad cells.

I write this with my daughter, Hunter, sleeping peacefully on my lap. As I look down on her, I am filled with a sense of awe, and of gratitude, for her journey to us was long. Here is her story......

From the time I was 14, I had horrible cramping with my periods. I would get sick each month and end up spending a week out of every month in bed. This just became "routine" for me and continued on throughout my teen years.

I'm pregnant. Big deal? It is for me. I've had one live birth and four losses. We've also done the full arsenal of infertility treatments. This is pregnancy number six and "she" is the result of IVF/ICSI. As happy as we are, all good news is received cautiously.

According to B. Russell’s “bad luck” mathematical paradox, a decision is bound to be false if based on the probability of success of another decision. Thus, a decision to perform a cesarean section (CS) based on the probability of a successful vaginal delivery (VD) is likely to be wrong.

European principles of giving birth were first introduced into the Pacific by missionaries in the early nineteenth century as part of their belief in civilising the local population. Formal medical practices were not introduced until some forty years later; then they were based only in the urban centres, almost unreachable for many Fijian women from their villages.

Whereas the surgical approach has long been the standard of care for ectopic pregnancy, a wider range of treatment options is now available--leading to a number of questions for the OB/GYN. Our expert panelists debate the relative merits and drawbacks of methotrexate and various invasive procedures, and also discuss their preferred diagnostic approaches, in managing the patient who presents with signs and symptoms of ectopic pregnancy.

Multiple gestation is the medical term that refers to a woman who is pregnant with twins, triplets, or other higher-order multiple pregnancies. This will occur in slightly less than 2% of all pregnancies. Within the category of multiple gestation, twin births are by far the most common, accounting for 95% of all multiple pregnancies.

In contrast to the pattern seen with singleton births, twins born to older mothers do not appear to have a greater risk of birth complications than do twins born to younger mothers, according to a recent study by researchers at the National Institute of Child Health and Human Development (NICHD) and the University of Kansas.

The word "ectopic" means "out of place." An ectopic pregnancy is a pregnancy that is not growing in the usual location (the uterine cavity). Ectopic pregnancies can occur in a number of abnormal locations, each with different characteristic growth patterns and treatment options.

Ectopic pregnancy, or preembryo implantation outside the endometrial cavity (i.e., fallopian tube, cervix, abdominal or pelvic cavity), is a potentially fatal condition with an incidence of ~1:150 diagnosed pregnancies.

As soon as a pregnancy becomes recognized, each (prospective) parent generally starts to accept and plan for their new arrival. If the pregnancy is lost, this is often considered a "death within the family" and the couple will go through an intense grieving process. The loss of a pregnancy can be devastating for a couple, regardless of the number of children in the family or the cause for the loss.

"What is the hardest of all to do? To see with our eyes what our eyes lay before us. (Paraphrased, with apologies from Goethe) That essentially is the message of the innovative efforts of Ms. Deborah Bush, Chairperson of the New Zealand Endometriosis Foundation. She has developed an interactive Menstrual Health and Endometriosis Education Program that has been presented to over 40,000 young women (ages 15-24), educators and clinicians.

I’m just back from holiday which as all OBGYN’s know is never a complete break. The usual scenario at the beach/bar/restaurant; Interested person "Oh so you’re an OBGYN, I know you’re on holiday but what do you think about my/our periods/fertility problems/pelvic pain?"

Chronic pelvic pain, a common complaint in female adolescents, is defined as cyclic or noncyclic, intermittent or constant discomfort in the pelvic region for at least 6 months. It often frustrates the patient, her parents, and her physician, and it can lead to major functional problems such as changes in family dynamics or school absenteeism.

Chronic pelvic pain can be defined as cyclic or non-cyclic pain of six or more months in duration that localises to the anatomical pelvis and is severe enough to cause functional disability and require medical or surgical treatment.

Endometriosis is a disease in which endometrial glands and stroma implant and grow in areas outside the uterus . The most common place to find implants is in the peritoneal cavity, but they can be found in any other place.

A pain score is being used to monitor women with a history of chronic pelvic pain. The total score for each day of the month is plotted into a graph and is later correlated to patient's daily activities in order to help with the diagnosis of baseline gynecological conditions.

The basic research of visceral pain mechanisms does not explain the chronic pelvic pain phenomena a gynecologist confronts in the clinic. There is, however, a link between the basic research and the acute gynecologic pain processes observed in the emergency room.

Adhesions occur after almost every abdominal surgery and are the leading cause of intestinal obstruction. Here, tips for adhesion prevention and how to correct them when they do occur are provided.